Brief Answer:
sparkles (PHOSPHENES) could be from headaches 2nd to IIH

Detailed Answer:
Hello there and thank you for your question. I've read your other questions and their responses so I know you've had some degree of testing in the past of your heart and blood pressure which seem to be panning out normally.

If you do have a TRUE DIAGNOSIS of pseudotumor cerebri then, you may like to know that the modern terminology of this condition is now IDIOPATHIC INTRACRANIAL HYPERTENSION (IIH). You didn't mention how your doctor came by this diagnosis and what your complaints were that would've prompted someone to test for this condition.

There are a number of symptoms that go along with IIH with one of the major ones being that of HEADACHE (usually severe). You mention sparkles of light in your peripheral vision which are the usual description people give of either migraine with aura or the rather rare entity called RETINAL MIGRAINES (which are often confused with OCULAR MIGRAINE).

And so the bottom line here to know best what is going on is be certain of the diagnosis of IIH which can be mistaken for other things such as migraine with aura especially if you may be a heavy set woman of childbearing age or if you are ingesting a large of vitamin A or taking medications such as retinol for conditions such as acne or other medications such as lithium, steroids injected into the spinal fluid, tetracyclines, and other medications.

So the sparkles or phosphenes you describe could be part of a headache syndrome which itself would likely be SECONDARY to the increased intracranial pressure. Direct and definitive treatment of the IIH should therefore, result in the eradication of these sparkles and indeed the associated headaches (if such exist).

Blood pressure is not related to the diagnosis of IIH or the sparkles you refer to which could be part of a headache syndrome. The increased pressure in the head is thought to be as a result of cerebrospinal fluid congestion and obstruction of drainage which when relieved typically relieves the consequences of IIH.

Recapitulating, if I were treating someone with your symptoms I would work to first verify the diagnosis of IIH (or pseudotumor cerebri) then, once it's established that IIH is present then, I would move to treat the condition with proper medications for the purpose of lowering the intracranial pressure which does not include treating systemic blood pressure. Surgical interventions are also a possibility if medications don't do the job.

If I've provided useful or helpful information could you do me a HUGE favor by CLOSING THE QUERY and taking a moment to provide a few kind words of feedback, perhaps even stamping the consult with a 5 STAR rating if you feel so inclined?

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I'm very interested in being kept in the loop with how things progress so please drop me a line whenever you seem to be turning the corner or if you end up getting some testing done. I'm happy to give you opinions on those issues as well.

This query has utilized a total of 60 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Be happy to review and opine on the REPORT of the MRI

Detailed Answer:
Hello and many thanks for offering CD images.

Unfortunately, this platform does not possess the necessary software engine in order to view CD files of MRI's. There are hundreds of images and many sequences that are printed to disk which SHOULD BE LOOKED at in a certain logical order and compared back to other images at the same time using specific software contained on the CD disk itself.

Looking only at select images (which is all that is really possible on a telemedicine site such as HEALTHCAREMAGIC) is not a proper way to evaluate MRI studies. Unfortunately, I must admit that colleagues of mine seem to resort to this kind of partial analysis of what should really be a full review of ALL IMAGES and all obtained sequences lest details be missed.

And you know WHO "lives in the details" don't you? HA!

I always tell my residents in training, "Answering the question of WHO lives in the details of any work, project, or other production effort is easy. It's either GOD or THE DEVIL." I look at the residents/students with perplexed expressions on their faces (having nothing to do with the fact they are too bleary eyed at 7a to know which way is up...so I help them.

I go on. "Well, the answer really depends on whether you are one who likes doing a job to PERFECTION or someone who doesn't mind BEING EMBARRASSED by not having done a job to PERFECTION." They then, continue to roll their eyes at me and each other BUT then, over the course of the rotation with me (usually 1-2 months) and after looking at HUNDREDS of images PER PATIENT before even attempting to make a diagnosis...most of them actually get it! WOW! I then, reask the question at the end of the term and am happy to say that MOST (not all) but MOST understand that the right answer to that question should be "God" meaning that they are people driven to perform tasks perfectly! LOL!

Do they carry that into practice? Well, I'm sure not all do....but I'm convinced that the exercise I oblige them to engage in for those couple of months does result in at least ONE physician/neurologist to buy into the concept and make it part of the style of practice....Good medicine happens...1 doctor at a time!

However, putting that little rant aside for a moment, you get the idea.....this site can't handle an entire CD ROM of images and so the next best thing would be the report.

I'd be happy to opine on the MRI report which can be easily uploaded as a PDF file. BTW, I believe I'm still awaiting an answer on a previous question having to do with THE DIAGNOSTIC BASES for someone telling you that you had PSEUDOTUMOR CEREBRI. It's perfectly fine if you're not sure on how to answer that...but I thought I'd ask since you appeared to have some degree of insight into your problem by reading some independent material so I thought I'd check to see if either anyone EXPLAINED to you how certain diagnoses were being made or whether you asked directly for that information.

I'll check back tomorrow to see if you were able to post the RADIOLOGY REPORT on the brain (MRI, MRA, etc.).

Cheers!

This query has utilized a total of 102 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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